Oral contraceptives (OCs), a highly effective method of contraception if adherence is maintained, have been prescribed to women in the USA and globally for several decades. The American College of Clinical Pharmacology (ACCP) strongly recommends the enactment of an initiative that permits licensed US pharmacists to prescribe OCs on a national basis. This position of the ACCP, based on the overall safety and well-established efficacy of estrogen- and progestin-based OCs, will provide women with easy and timely access to OCs. To ensure safe and consistent implementation of this initiative, the ACCP recommends appropriate training requirements based on the US Medical Eligibility Criteria (US MEC) for contraceptive use.
Traditionally, OCs have been prescribed by non-pharmacy healthcare providers or through a physician's office. This has enabled adherence to OCs and has encouraged women to maintain routine gynecological care visits that may otherwise not occur. In addition, this practice has minimized contraindications, drug-drug interactions (DDIs), and safety issues in high-risk populations, and has enhanced face-to-face counseling on OC usage and adverse events. However, the current time and cost associated with a clinic appointment, lack of insurance, and challenges in traveling to a clinic make access to OCs difficult. This is particularly challenging for women in socio-economic strata with limited or no healthcare access. This lack of access to effective contraception leads to a high risk of unintended pregnancies. Pharmacist-prescribed access for OCs is expected to be supported by women, pharmacists, and medical organizations involved in women's health. A review of 4 observational studies compared the effectiveness and usage of OCs where access was provided through a pharmacy (either over the counter or as a prescription from the pharmacist), versus physician-based prescription access. The review concluded that there was a higher rate of continuous OC usage when the products were available through OTC or prescription by pharmacist, relative to access through a physician's office. The review also found that women generally preferred to access OCs through a pharmacy rather than through the physician's office.
According to the collective knowledge available from the Centers for Disease Control and Prevention (CDC), the FDA, and the World Health Organization (WHO), as well as the reviews and published literature reports, the safety, efficacy, and benefits/risk of COCs are well understood. Prescribing COCs through pharmacy access, by licensed pharmacists, is not expected to increase the incidences of adverse events associated with COC usage.
